Donise B. Sheridan, O.D.
Individual provider Active NPI Optometrist · Mayfield, KY
NPI 1457325565 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1457325565
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1388DT (KY)
- Practice address
- 1400 Commonwealth Dr.
Mayfield, KY 42066 - Phone
- (270) 247-2417
- Fax
- (270) 247-2090
- NPI assigned
- Feb 15, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern College of Optometry, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Clarkson Optometry Midwest Inc
Practice addresses (Care Compare)
1400 Commonwealth Dr
Mayfield, KY 42066-6845
Phone (270) 247-2417
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 19 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100518000454 | KY | Practitioner - Optometry | 8527114305 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clarkson Optometry Midwest Inc | Optometrist | Current |
Accepting new patients |
| Clarkson Optometry Midwest Inc | Optometrist | Current |
Accepting new patients |
| 20-20 Eyecare PSC | Optometrist | Past | Accepting new patients |
Locations
3978 Alexandria Pike
Cold Spring, KY 41076
Phone (859) 441-8500
1400 Commonwealth Dr
Mayfield, KY 42066
Phone (270) 247-2417
Interoperability endpoints
- dsheridan@direct.eyecare-partners.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1388DT | KY | Yes |
Addresses
Primary practice location
1400 Commonwealth Dr.
Mayfield, KY 42066
Mailing address
1400 Commonwealth Dr
Mayfield, KY 42066
Phone (270) 247-2417
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 135441 | Other | KY | COLE MANAGED VISION |
| 390980 | Other | KY | HEALTHLINK |
| 5679620 | Other | KY | AETNA |
| 77013886 | Medicaid | KY | |
| U68612 | Other | KY | BLUEGRASS FAMILY HEALTH |
| 000000214672 | Other | KY | BLUE CROSS BLUE SHIELD |
Other providers in Mayfield, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.